One of the major causes of low back pain is sacroiliac, or “SI” joint dysfunctions. Many times it is overlooked when evaluating a back condition.
The two hip bones (ilium) are connected to the sacrum. The joint is an extremely stable structure because of the boney configuration and ligament support. The spine sits on the sacrum and is connected to the iliums.
SI dysfunction is the result of an injury. The ligament complex can be stretched or torn. Injuries leading to the problem include a strain or sprain, a fall, lifting with rotation from a forward flexed position or a moving vehicle accident. A chronic strain or sprain occurs from repetitive lifting, or a golf club swing. Other causes are muscle imbalances involving leg shortness, restricted hip motion or abnormal foot biomechanics.
Most common symptoms are pain in the lower back, buttocks, hips, or groin, radiating down the leg to the ankle (similar to lumbar disc patterns). One of the most frequent complaints is increased pain from sitting, standing, walking or lying down. This is how the SI dysfunction is different from disc-related problems. SI joint patients feel the need to be constantly moving to find a comfortable position , whereas disc patients often can find a comfortable position by unloading the spine by sitting or lying down. Also, SI joint symptoms intensify with activity and decrease with rest, while disc generated pain can be most severe in the morning.
The individual’s subjective complaints and a thorough physical evaluation are key to determining an SI dysfunction, along with a clear understanding of the difference in symptoms of SI dysfunction from other pathologies.
The healthcare practitioner needs to identify the aggravating factors in an attempt to restore the components that are causing the dysfunction. Teaching an individual exercises to self-correct the problem is important, followed by exercises based on the individual’s problem. Common exercises for the lower back may not adequately address the issue.
With a greater understanding of the problem by the individual and the healthcare practitioner working to reduce the cause, the risk of reoccurring back problems can be decreased.